Assessing the risk of false positive serum galactomannan among patients receiving piperacillin/tazobactam for febrile neutropenia


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Demiraslan H., ATALAY M. A., EREN E., Demir K., KAYNAR L., KOÇ A. N., ...Daha Fazla

MEDICAL MYCOLOGY, cilt.55, sa.5, ss.535-540, 2017 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 55 Sayı: 5
  • Basım Tarihi: 2017
  • Doi Numarası: 10.1093/mmy/myw129
  • Dergi Adı: MEDICAL MYCOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.535-540
  • Anahtar Kelimeler: piperacillin/tazobactam, galactomannan test, false positivity, generic formulations, febrile neutropenia, HEMATOLOGICAL DISORDERS, INVASIVE ASPERGILLOSIS, FUNGAL-INFECTIONS, ADULT PATIENTS, TAZOBACTAM, PLATELIA, DISEASES, ASSAY, DIAGNOSIS, ANTIGEN
  • Lokman Hekim Üniversitesi Adresli: Hayır

Özet

Galactomannan (GM) assay is commonly used as an early diagnostic tool for invasive fungal infection (IFI) in high-risk hematology patients. False positivity is frequently observed in GM with the use of piperacillin/tazobactam. The usage of generic drugs over the original brand has a significant cost advantage. The aim of this study was to assess the performance of GM test among patients receiving original and generic piperacillin/tazobactam formulations. The study included 85 adult patients; 62.4% were male with hematological malignancy currently receiving piperacillin/tazobactam. The study group was divided into two groups: patients receiving original and generic piperacillin/tazobactam. Serum GM index was positive in one of 35 patients receiving original piperacillin/tazobactam, whereas it was positive in 46 out of 50 patients receiving generic piperacillin/tazobactam (P <.001). However, the patients receiving generic piperacillin/tazobactam underwent computed tomography (CT) scans more frequently than those receiving original piperacillin/tazobactam (P =.047). In addition, in vitro analysis of GM was performed in two generics and one original piperacillin/tazobactam vials. One generic piperacillin/tazobactam vial included high GM level. False positivity of serum GM with generic formulations of piperacillin/tazobactam is still an ongoing issue in hematology patients. A high rate of serum GM index false positivity may unexpectedly lead to a higher rate of CT scan. Selected piperacillin/tazobactam vials in each batch should be checked for GM to identify a false positivity of GM before purchase.